Healthcare Provider Details

I. General information

NPI: 1134149024
Provider Name (Legal Business Name): JOHNNY EDROZO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17215 STUDEBAKER RD SUITE 300
CERRITOS CA
90703-2548
US

IV. Provider business mailing address

17215 STUDEBAKER RD SUITE 300
CERRITOS CA
90703-2548
US

V. Phone/Fax

Practice location:
  • Phone: 562-924-7307
  • Fax: 562-860-9398
Mailing address:
  • Phone: 562-924-7307
  • Fax: 562-860-9398

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberC51509
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberC51509
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: